GASTROESOPHAGEAL REFLUX DISEASE (GERD)

S. SORATHIA · 2026 · Case ID: A26040433

GRANTED

Summary

The veteran, who served from February 1978 to January 1985, appeals the continuation of a noncompensable rating for his service-connected GERD. The veteran sought an initial 10 percent disability rating effective May 31, 2019, based on VA treatment records showing a prescription for Omeprazole to control heartburn and reflux. The Board reviewed evidence including June 2022 and November 2023 VA examinations. The June 2022 exam diagnosed GERD but found it asymptomatic and not impacting work. The November 2023 exam diagnosed GERD, noting infrequent epigastric distress and pyrosis, treated with Omeprazone, and also found no work impact. VA treatment records through November 2023 were also considered. The Board found that the evidence supported a 10 percent rating for GERD, based on the presence of pyrosis and infrequent epigastric distress, applying the benefit of the doubt to find the distress more frequent than described. However, the Board found no evidence of dysphagia, substernal pain, or considerable impairment of health, precluding a higher rating. The Board acknowledged the use of medication but noted it did not preclude the 10 percent rating. The appeal regarding the effective date was declined as it was raised more than one year after the prior decision.

Rationale

Evidence of pyrosis and infrequent epigastric distress supports 10% rating.; Benefit of doubt applied to find epigastric distress more frequent than described.; No evidence of dysphagia, substernal pain, or considerable impairment of health to warrant higher rating.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

241113-645780

Full Decision Text

Citation Nr: A26040433
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 241113-645780
DATE: April 29, 2026

ORDER

An initial disability of 10 percent, and no higher, for GERD is granted.

FINDING OF FACT

Since the grant of service connection, the Veteran's GERD has been manifested by infrequent of episodes of epigastric distress and pyrosis, but has not manifested with recurrent epigastric distress with dysphagia, hematemesis or melena, or substernal, arm, or shoulder pain productive of considerable impairment of health.

CONCLUSION OF LAW

The criteria for an initial disability rating of 10 percent, and no higher, for GERD have been met. 38 U.S.C. § 1155, 5107; 38 C.F.R. §§ 4.1-4.16, 4.114, DCs 7399-7346.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active service from February 1978 to January 1985.?

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2023 rating decision of a VA AOJ which continued a noncompensable rating for the Veteran's service-connected GERD effective September 24, 2019.

In a November 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement (NOD)), the Veteran appealed the November 2023 rating decision, electing the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the November 2023 AOJ decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Notably, the November 2024 NOD also noted disagreement with the assigned effective date of September 2019. However, for the reasons below, the Board has limited this appeal to the issue of entitlement to an initial increased rating. Significantly, a May 2021 rating decision granted service connection for GERD, assigning a noncompensable disability rating effective May 31, 2019. The effective date was later changed to September 24, 2019, in a June 2022 rating decision. While the Veteran later sought review of the June 2022 rating decision by way of a July 2023 supplemental claim, the Veteran specifically disagreed with the "evaluation" assigned in the June 2022 rating decision and does not include any disagreement as to the effective date. As above, the November 2023 rating decision on appeal continued a noncompensable disability rating for the Veteran's GERD effective September 24, 2019. The first time disagreement with the September 24, 2019, effective date was raised was in the November 2024 NOD, more than one year after the June 2022 rating decision assigning the September 24, 2019 effective date. As such, the Board declines to consider the issue of entitlement to an effective date earlier than September 24, 2019, for the grant of service connection for GERD.

Legal Criteria

Disability ratings are determined by applying the criteria set forth in the VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity resulting from disability.? Separate diagnostic codes identify the various disabilities.? 38?U.S.C. §?1155; 38?C.F.R. §?4.1.?

If two ratings are potentially applicable, the higher rating will be assigned if the disability picture more nearly approximates the criteria for the higher rating.? Otherwise, the lower rating will be assigned.? 38?C.F.R. §?4.7.? Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran.? 38?C.F.R. §?4.3.?

The United States Court of Appeals for Veterans Claims (Court) recently held that the Board must take due consideration that the beneficial effects of medication
impairment of earning capacity resulting from disability.? Separate diagnostic codes identify the various disabilities.? 38?U.S.C. §?1155; 38?C.F.R. §?4.1.?

The United States Court of Appeals for Veterans Claims (Court) recently held that the Board must take due consideration that the beneficial effects of medication are discounted unless such effects are otherwise contemplated in a particular DC. See Ingram v. Collins, 38 Vet. App. 130 (2025).

A veteran's entire history is to be considered when assigning disability ratings.? 38?C.F.R. §?4.1; Schafrath v. Derwinski, 1?Vet. App.?589 (1995).? The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal.? Fenderson v. West, 12?Vet. App.?119 (1999); Hart v. Mansfield, 21?Vet. App.?505 (2007).?

Analysis

The Veteran contends that his GERD is more disabling than currently evaluated. Specifically, in the March 2024 NOD, the Veteran's representative requested an initial 10 percent disability rating effective May 31, 2019, based on VA treatment records documenting a prescription for Omeprazone to control the Veteran's GERD symptoms, which include heartburn and reflux.

The Veteran's GERD, is rated by analogy under 38 C.F.R. § 4.114, DCs 7399-7346. Under DC 7346, a 10 percent evaluation is warranted when there are two or more of the symptoms for the 30 percent evaluation of less severity. A 30 percent evaluation is warranted when there is persistently recurrent epigastric distress with dysphasia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. A 60 percent evaluation contemplates a level of impairment which includes symptoms of pain, vomiting, material weight loss and hematemesis or melena with moderate anemia; or other symptom combinations productive of severe impairment of health. 38 C.F.R. § 4.114, DC 7346.

Note (1) to DC 7346 indicates that abdominal pain in this condition must be confirmed as resulting from pancreatitis by appropriate laboratory and clinical studies.

Dysphagia is defined as difficulty in swallowing. Dorland's Illustrated Medical Dictionary, 587 (31st ed. 2007). Pyrosis is defined as heartburn. Id. at 1587. Hematemesis is defined as the vomiting of blood. Id. at 842. Melena is defined as the passage of dark-colored feces stained with blood pigments or with altered blood. Id. at 1142.

By way of history, service connection for GERD was granted by rating decision dated in May 2021 and a noncompensable disability rating was assigned effective May 31, 2019. The Veteran sought higher-level review (HLR) of the May 2021 rating decision and in a June 2022 rating decision, the AOJ assigned a later effective date assigned for this award to September 24, 2019, and, in a third June 2022 rating decision, the AOJ continued the noncompensable disability rating assigned. The Veteran then submitted a supplemental claim, seeking a higher rating for his service-connected GERD and a November 2023 rating decision continued the noncompensable disability rating originally assigned. The Veteran disagreed with this decision and perfected an appeal.

Evidence relevant to the level of severity of the Veteran's GERD includes June 2022 and November 2023 VA esophageal condition examination reports. During the June 2022 VA examination, the examiner noted a diagnosis of GERD. Significantly, the examiner found that the Veteran's GERD was asymptomatic. Physical examination was negative for esophageal stricture, spasm of esophagus (cardiospasm or achalasia), or an acquired diverticulum of the esophagus. There were no scars or any other pertinent physical findings. The examiner found that the Veteran's esophageal condition did not impact his ability to work.

The Veteran disagreed with this decision and perfected an appeal.

During the November 2023 VA examination, the examiner continued a diagnosis of GERD. The Veteran reported that he experienced infrequent of episodes of epigastric distress and pyrosis and that he was treating his symptoms with Omeprazone. Physical examination was negative for esophageal stricture, spasm of esophagus (cardiospasm or achalasia), or an acquired diverticulum of the esophagus. There were no scars or any other pertinent physical findings. The examiner found that the Veteran's esophageal condition did not impact his ability to work.

Also of record are VA treatment records dated through November 2023. Significantly, these records show findings similar to those above.

Upon review of the record, the Board finds that a 10 percent rating for GERD is warranted. The records contain evidence of pyrosis (heartburn) and episodes of epigastric distress. These are two symptoms at the 30 percent level, which allows for a 10 percent rating. While the epigastric distress at the 30 percent level is characterized as "persistently recurrent" and the November 2023 VA examination report shows that the Veteran's episodes or epigastric distress are "infrequent" the Board will give the Veteran the benefit of the doubt in finding that the Veteran's epigastric distress is more frequent than described given the totality of the medical and lay evidence. As for the potential for an even higher rating the record is devoid of complaints of dysphagia (difficulty swallowing) and substernal, arm, or shoulder pain that is due to GERD. Also, there is no showing of considerable impairment of health due to GERD. With evidence of two or more of the symptoms for the 30 percent rating of less severity, entitlement to a 10 percent rating is established. In the absence of additional symptoms, however, a higher still rating is not warranted.

The Board acknowledges that the Veteran takes prescription medication to control his symptoms and that the Board may not deny a higher rating on the basis of relief provided by medication when those effects are not specifically contemplated by the rating criteria. See Jones v. Shinseki, 26 Vet. App. 56, 63 (2012). Here, medication is shown to relieve pyrosis. The symptom of pyrosis is considered in the grant to 10 percent. As such, even considering that the Veteran must take medication, a 10 percent rating, but not higher, is warranted.

S. Sorathia

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board April Maddox, Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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